Chocolate cyst became ovarian abscess following IVF: a serious surgical emergency

Abstract

We are reporting a rare case of ovarian abscess in an endometrioma following ultrasound guided oocyte retrieval during in vitro fertilization technique. Ovarian abscess within an endometrioma is a rare gynaecological problem. We are presenting a case of a giant abscess formation in an endometrioma following in vitro fertilization in a 36-year-old woman in view of secondary infertility. She presented with high grade fever with chills and rigor for more than 2 months associated with pain in abdomen with a progressively increasing lower abdominal mass. Patient was treated at a tertiary care hospital with multidisciplinary approach. Laparotomy was performed, and two litres of the foul-smelling pus was drained, followed by bilateral salpingooophorectomy. Uterus was left in situ to preserve her future fertility potential. Histology of the specimen confirmed endometriotic nature of the cyst. Pus on culture sensitivity was sterile. Patient had an uneventful recovery and was discharged on the 7th post-operative day. In our case endometrioma presented as failure of in vitro fertilization technique followed by a medical illness. This case highlights that endometrioma became not only a cause of failure of in vitro fertilization technique but also presented as a medical illness and should be dealt as one.